What are the ACP guidelines for the treatment of acute and recurrent gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

ACP recommendations for the treatment of acute and recurrent gout attacks are as follows [153] :

  • Use corticosteroids, NSAIDS, or colchicine to treat acute gout
  • Use low-dose colchicine (1.2 mg, then 0.6 mg 1 hr later) when using colchicine for acute gout
  • Recommend against initiating long-term urate-lowering therapy in most patients after a first gout attack or in patients with infrequent attacks
  • Discuss benefits, harms, costs, and individual preferences with patients before initiating urate-lowering therapy, including concomitant prophylaxis, in patients with recurrent gout attacks

In contrast to American College of Rheumatology recommendations, the ACP concluded that evidence was insufficient to determine whether the benefits of escalating urate-lowering therapy to reach a serum urate target outweigh the harms associated with repeated monitoring and medication escalation. [153]


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